| NPI | 1487130050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 10482) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health (Licence: CA 10482) | |
| 225400000X Rehabilitation Practitioner (Licence: CA 10482) | |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2025-04-10 |